Staci Lynn Davis, LPC
Individual provider Active NPI Mental Health Counselor · Fulshear, TX
NPI 1023747839 · NPPES record last updated Jun 8, 2022
Key facts
- NPI
- 1023747839
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 75251
- Practice address
- 29142 Crystal Rose LN
Fulshear, TX 77441-1772 - Phone
- (281) 344-7832
- NPI assigned
- Jun 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 75251 | Yes |
Addresses
Primary practice location
29142 Crystal Rose LN
Fulshear, TX 77441-1772
Mailing address
29142 Crystal Rose LN
Fulshear, TX 77441-1772
Phone (281) 344-7832
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- Jordyn Dean
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All providers in Fulshear, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.